Assessing the Effects of Stove Use Patterns and Kitchen Chimneys on Indoor Air Quality during a Multiyear Cookstove Randomized Control Trial in Rural India.

We conducted indoor air quality (IAQ) measurements during a multiyear cookstove randomized control trial in two rural areas in northern and southern India. A total of 1205 days of kitchen PM 2.5 were measured in control and intervention households during six ∼3 month long measurement periods across two study locations. Stoves used included traditional solid fuel (TSF), improved biomass, and liquefied petroleum gas (LPG) models. Intent-to-treat analysis indicates that the intervention reduced average 24 h PM 2.5 and black carbon in only one of the two follow-up measurement periods in both areas, suggesting mixed effectiveness. Average PM 2.5 levels were ∼50% lower in households with LPG (for exclusive LPG use: >75% lower) than in those without LPG. PM 2.5 was 66% lower in households making exclusive use of an improved chimney stove versus a traditional chimney stove and TSF-exclusive kitchens with a built-in chimney had ∼60% lower PM 2.5 than those without a chimney, indicating that kitchen ventilation can be as important as the stove technology in improving IAQ. Diurnal trends in real-time PM 2.5 indicate that kitchen chimneys were especially effective at reducing peak concentrations, which leads to decreases in daily PM 2.5 in these households. Our data demonstrate a clear hierarchy of IAQ improvement in real world, "stove-stacking" households, driven by different stove technologies and kitchen characteristics.